TORONTO —
Face masks, originally seen as unnecessary outside hospitals and now facing global shortages, could be re-emerging as a new normal for daily life during the coronavirus pandemic.
As the crisis evolves daily, so does expert guidance, but there has been much mixed messaging around face masks in particular.
The White House recently signalled that the U.S. Centers for Disease Control and Prevention would be issuing new guidance in the coming days and recommending the widespread use of face masks.
But in a tweet Saturday, the CDC denied such claims. Currently, the group recommends only health care professionals and people who have COVID-19 and are showing symptoms wear a face mask. You do not need to wear a face mask in your own home.
“CDC does not recommend that people who are well wear a facemask (sic) to protect themselves from respiratory illnesses, including COVID-19,” reads the center’s FAQ page for the virus.
The Public Health Agency of Canada currently provides the same messaging for Canadians: If you’re healthy, you don’t need a mask to prevent the spread. “Wearing a mask when you are not ill may give a false sense of security,” the agency says online, adding that there are risks associated with masks: they need to be changed frequently and improper disposal could increase infection risk.
It’s a message that Chief Public Health Officer Dr. Theresa Tam reiterated in a press conference on Monday.
“What we worry about is actually the potential negative aspects of wearing a mask, where people are not protecting their eyes or other aspects of where the virus could enter your body, and that gives you a false sense of confidence,” Tam said.
“But also, it increases the touching of your face. If you think about it, if you’ve got a mask around your face sometimes you can’t help it.”
Last week, Health Canada released a warning about homemade masks, advising Canadians that they should be used with caution and have several limitations that surgical masks and respirators do not. Homemade masks have not been tested “to recognized standards.” They may not provide “complete protection” against viruses. They may be difficult to breathe through and made with ineffective fabric. They may also be loose-fitting and require frequent adjustments that would increase hand-to-face contact.
“Homemade masks are not medical devices and consequently are not regulated, like medical masks and respirators,” the agency wrote. “These types of masks may not be effective in blocking virus particles that may be transmitted by coughing, sneezing or certain medical procedures. They do not provide complete protection from the coronavirus because of a potential loose fit and the materials used.”
Meanwhile, other experts have started to suggest more widespread use of the protective gear. On Sunday, infectious disease specialist Dr. Abdu Sharkawy told CTV National News that he wears a mask whenever he’s out in public and could come in contact with other people.
WHEN TO WEAR A MASK
“The simple answer is if you are going to be anywhere near contact with someone else—especially not within your nuclear household—it’s a good idea to wear a mask,” he said, emphasizing that Canadians should not be interacting in-person with anyone who doesn’t live in their home.
If you decide to go for a walk, it’s “not a bad idea” to wear a mask, but you shouldn’t have to: “You shouldn’t be going for walks with anyone except the people within your own nuclear household,” he said.
The grocery store is a different story. While many have instituted precautions—from new capacity rules to plexiglass barriers at registers—it’s difficult to control other people’s adherence to physical distancing.
“It’s going to be nearly impossible to maintain a distance of six feet at all times,” said Sharkawy. “If you’re going to the grocery store to pick up your groceries for the week, you should be wearing a mask.”
At home, masks are not necessary, he added.
“You’re in the same environment as everybody else (at home). You’re breathing the same air. If you go outside your front door, you don’t need a mask,” he said. “But if you’re out in public and anywhere near exposure with other people not within your nuclear household, you should ideally wear a mask.”
GLOBAL SHORTAGES
Despite the suggestion that more people wear facial protection, there are escalating shortages of medical supplies, including face masks, around the world.
There have been reports of hospitals even rationing masks, limiting staff to one or two per day. To help leave more masks for the front-line workers and patients, there have been an increasing number of charitable efforts around the world, with groups donating thousands of masks to hospitals, including the stockpiles of the Bank of China and prop masks from the set of Grey’s Anatomy.
Last week, a Toronto hospital appealed for volunteers to help sew 1,000 new surgical masks every week for visitors and discharged patients, citing the “worldwide shortage of personal protective equipment.” Even this effort came with a call for more people to wear masks in public.
“We want to see all east enders (in Toronto) wearing a fabric mask when they need to be within six feet of other people, especially vulnerable populations and the elderly,” wrote Dr. Jeff Powis, of the Michael Garron Hospital, in a news release.
WHAT TYPE OF MASK?
While there is evidence to suggest that only N95 respirator masks, which have built-in filters, are effective at protecting the wearer from harmful particles, Dr. Sharkawy told CTV National News that there is enough evidence to suggest even makeshift masks will suffice, though they won’t necessarily prevent the wearer from getting sick.
“Anything that covers your nose and your mouth with a reasonable seal. You can fashion out of cloth, you can fashion even out of a vacuum bag,” he said. “As long as it can stand a little bit of humidity, that’s very useful. If it’s something that’s reusable that’s cloth that can be washed, that’s also very reasonable.”
Still, face masks should not be used as a substitute for the more vital precautions like frequent hand washing and staying at home. Sharkawy himself wears a mask outside when he may be in contact with others, but the safety measures don’t stop there.
“I’m taking exceedingly strict precautions in terms of hand washing regularly,” he said, “and physically distancing absolutely at all times.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
